NPIMap

Organization Active NPI

Upper Valley Family Medicine PA

  • Physician Assistant
  • Rigby, ID
National Provider Identifier
1679737217
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
UPPER VALLEY FAMILY MEDICINE PA
Practice address
530 Rigby Lake Dr
Rigby, ID 83442-1271
Phone
(208) 745-5021
Fax
(208) 745-5026
NPI assigned
Jul 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Connie Lynn Safarik, CPC
Title
Office Manager
Phone
(208) 745-6717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X Primary

Addresses

Primary practice location

530 Rigby Lake Dr
Rigby, ID 83442-1271

Mailing address

530 Rigby Lake Dr
Rigby, ID 83442-1271
Phone (208) 745-5021

National Provider Directory

National Provider Directory
Tax ID family
Upper Valley Family Medicine PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1679737217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 RIGBY LAKE DR",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834421271",
            "telephone_number": "208-745-5021",
            "fax_number": "208-745-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 RIGBY LAKE DR",
            "city": "RIGBY",
            "state": "ID",
            "postal_code": "834421271",
            "telephone_number": "208-745-5021",
            "fax_number": "208-745-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER VALLEY FAMILY MEDICINE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "SAFARIK",
        "authorized_official_first_name": "CONNIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-745-6717",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rigby, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.